Characterization of Guillain-Barré Syndrome in the integrated development region of the Federal District and Surrounding Areas (RIDE), Brazil, between 2017 and 2019.

INTRODUCTION: Guillain-Barré Syndrome (GBS) is an acute immune-mediated polyneuropathy that primarily affects the peripheral nerves. Following the Zika virus outbreak in Latin America, all the Latin American and Brazilian studies conducted reported an increase in the incidence of GBS. The present study aims to characterize the clinical and demographic profile of patients with GBS, according to electrophysiological estudies. METHODS: This is a clinical cohort study based on data from medical charts and interviews conducted at the homes of GBS cases identified by three data sources, admitted to and treated at a tertiary referral hospital between March 2017 and May 2019. RESULTS: There was a high level of diagnostic certainty among the 51 GBS cases monitored, with most classified as exhibiting acute inflammatory demyelinating polyneuropathy (AIDP). The majority of the individuals were of working age, with an average schooling level. Diarrhea and upper respiratory tract infection were the previous events most reported. Most cases were admitted to the hospital unable to walk and the main complication identified was aspiration pneumonia. CONCLUSION: The findings indicate the need to rethink the care of patients with GBS in order to minimize the possibility of future complications during hospitalization that may lead to unfavorable outcomes.

Costs of Guillain-Barré Syndrome in the Brazilian Federal District: the patients' perspective.

BACKGROUND: Although rare, Guillain-Barré Syndrome (GBS) has a high economic burden, with consequences for families and society. This study aimed to estimate the total cost of GBS, per individual and per variant of the disease, as well as its effect on household income, from the perspective of patients. METHODS: This was a cost-of-illness study from the perspective of patients and their families, with a time horizon from disease onset to 6 mo after discharge. The total cost of GBS was estimated by bottom-up microcosting, considering direct and indirect costs. RESULTS: The median cost of GBS per individual was US$1635.5, with direct costs accounting for 64.3% of this amount. Among the variants analyzed, acute motor sensory axonal neuropathy (US$4660.1) and acute inflammatory demyelinating polyneuropathy (US$2017.0) exhibited the highest costs compared with acute motor axonal neuropathy (US$1635.5) and Miller Fisher Syndrome (US$1464.8). The costs involved compromise more than 20% of the household income of 22 (47.8%) patients. CONCLUSIONS: This study demonstrated how costly GBS can be. It is hoped that decision-makers will analyze these results with a view to improving the structure of healthcare services.

Sensitivity of Guillain-Barre Syndrome Surveillance in the Brazilian Federal District, using the Capture-Recapture Method.

INTRODUCTION: Guillain-Barre Syndrome (GBS) is an acute immune-mediated polyneuropathy that compromises the peripheral and cranial nerves. It is characterized by rapid-onset paresthesia accompanied by progressive weakness in the lower extremities followed by symmetric ascending paralysis. METHODOLOGY: assessment of sensitivity to detect GBS between March 2017 and May 2019 in a public referral hospital, using the capture-recapture method based on the Chapman estimator and comparing three GBS data sources: the hospital-based sentinel surveillance system (VSBH), Human Immunoglobulin Dispensing Records System (RDIH), and Hospital Information System (SIH). RESULTS: A total of 259 possible cases were identified (captured). Of these, 58 were confirmed and most resided in the Federal District. The VSBH showed the greatest sensitivity in case identification. The temporal distribution of cases showed periods with no cases identified, and more were registered during the rainy season from October to May, when high temperatures also occur. CONCLUSIONS: Increased circulation of arboviruses and gastrointestinal infections during the rainy season may explain the greater concentration of GBS cases. It is important to note that one-third of the cases identified in the different data sources do not converge, demonstrating that no single surveillance system is 100% effective. The severity and possible increase in cases related to GBS demonstrates the need for an improved surveillance system capable of monitoring and following-up cases involving neurological syndromes, regardless of the event preceding infection.

Reflexões sobre as bases conceituais das DiretrizesCurriculares Nacionais em cursos de graduação emsaúde / Reflections on the conceptual basis of the National Curriculum Guidelinesfor the health degree courses

A necessidade de mudanças na formação profissional em saúde temmobilizado as profissões da área de maneira expressiva. As discussõesocorrem em torno da necessidade de se implementar as transformaçõessugeridas nas Diretrizes Curriculares Nacionais para oscursos graduação na área da saúde. A grande maioria dos cursostiveram suas diretrizes publicadas entre 2001 e 2004. Para a graduaçãoem Medicina há uma recente publicação, ocorrida em 2014.Este artigo busca promover uma reflexão no que se refere às basesconceituais norteadoras das competências e habilidades gerais propostasneste documento, com ênfase nos cursos de Enfermagem,Medicina e Odontologia. Destacamos a formação do profissionalgeneralista, a integralidade da atenção e o trabalho em equipe, ressaltandoos desafios a serem superados.(AU)

The issues related to the required changes in health professionaleducation have been addressed by the health professions in a expressiveway. The discussions are around the need to reach thetransformations proposed by the Curricular Guidelines for undergraduatehealth courses. The majority of the courses had the referreddocument published between 2001 and 2004. There is a recentpublication for the undergraduate degree courses in Medicine, occurredin 2014. This article aims to bring a reflection about the conceptualbasis of the general competencies and abilities proposed onthe current guidelines, emphasizing the degrees of Nursing, Medicineand Dentistry. We addressed mainly the role of the generalpractitioner professional, the comprehensiveness and team work,highlighting the challenged still to be faced and to be overcome.(AU)

Reflexões sobre as bases conceituais das DiretrizesCurriculares Nacionais em cursos de graduação emsaúde / Reflections on the conceptual basis of the National Curriculum Guidelinesfor the health degree courses

A necessidade de mudanças na formação profissional em saúde temmobilizado as profissões da área de maneira expressiva. As discussõesocorrem em torno da necessidade de se implementar as transformaçõessugeridas nas Diretrizes Curriculares Nacionais para oscursos graduação na área da saúde. A grande maioria dos cursostiveram suas diretrizes publicadas entre 2001 e 2004. Para a graduaçãoem Medicina há uma recente publicação, ocorrida em 2014.Este artigo busca promover uma reflexão no que se refere às basesconceituais norteadoras das competências e habilidades gerais propostasneste documento, com ênfase nos cursos de Enfermagem,Medicina e Odontologia. Destacamos a formação do profissionalgeneralista, a integralidade da atenção e o trabalho em equipe, ressaltandoos desafios a serem superados...

The issues related to the required changes in health professionaleducation have been addressed by the health professions in a expressiveway. The discussions are around the need to reach thetransformations proposed by the Curricular Guidelines for undergraduatehealth courses. The majority of the courses had the referreddocument published between 2001 and 2004. There is a recentpublication for the undergraduate degree courses in Medicine, occurredin 2014. This article aims to bring a reflection about the conceptualbasis of the general competencies and abilities proposed onthe current guidelines, emphasizing the degrees of Nursing, Medicineand Dentistry. We addressed mainly the role of the generalpractitioner professional, the comprehensiveness and team work,highlighting the challenged still to be faced and to be overcome...